Pain Management Flashcards

1
Q

What is nociceptive pain ?

A

Arises from direct activation of nociceptors located in the peripheral somatosensory nervous system

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2
Q

What is neuropathic pain ?

A

Pain occurring with an abnormally functioning somatosensory nervous system

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3
Q

If nociceptive pain is somatic how would the pain be described ?

A

Sharp, aching or throbbing

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4
Q

If nociceptive pain is visceral how would the pain be described ?

A

Crampy

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5
Q

How is neuropathic pain described ?

A

Burning, tingling
Numbness
Shooting
Stabbing
Electric like feelings

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6
Q

What can cause neuropathic pain as a result of a primary nervous system lesion ?

A

Ischaemia
Compression
Infiltration
Metabolic injury
Transaction of the nerve

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7
Q

What are the 3 major categories of pain syndromes in cancer ?

A

Direct tumour involvement
Pain associated with cancer therapy
Pain not related to therapy or cancer

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8
Q

What are the 3 steps of the WHO analgesic ladder ?

A

Non-opioid analgesics - paracetamol and NSAIDs

Weak opioids - codeine and tramadol

Strong opioids - fentanyl, morphine, oxycodone

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9
Q

How do NSAIDs work ?

A

Inhibiting cycle-oxygenate which is an enzyme that converts arachidonic acid to prostaglandins.

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10
Q

What are some adverse effects of NSAIDs ?

A

Gastropathy
Renal failure
Inhibition of platelet aggregation

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11
Q

If dehydrated or have renal failure what alterations should be made for opioids ?

A

Doses should be lower than normal with increased intervals between doses to avoid excessive accumulation of active drug.

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12
Q

What are some common adverse effects of opioids ?

A

Constipation
Sedation
Nausea and vomiting

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13
Q

What are some steroid adjuvants for pain management ?

A

Prednisolone
Dexamethasone

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14
Q

What are some antidepressants adjuvants for pain management ?

A

Amitriptyline

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15
Q

What are some anxiolytic adjuvants for pain management ?

A

Diazepam
Lorazepam

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16
Q

What are some anticonvulsants adjuvants for pain management ?

A

Gabapentin
Clonazepam

17
Q

What are some medications for neuropathic pain ?

A

TCA’s
Anticonvulsants
Clonazepam

18
Q

What are some mediations for visceral pain ?

A

Steroids
Anti-spasm agents

19
Q

What are some medications for somatic soft tissue pain ?

A

NSAIDs
Steroids

20
Q

What are some medications for bone pain ?

A

NSAIDs
Bisphosphonates
Calcitonin

21
Q

What are some weak opioids ?

A

Codeine

22
Q

What are some strong opioids ?

A

Fentanyl
Oxycodone
Morphine

23
Q

When can radiation therapy be used for pain relief ?

A

Bone mets
CNS involvement
Visceral pain
Pain due to obstruction

24
Q

Where are opioids broken down and excreted ?

A

Metabolised - liver
Excreted - kidneys

25
Q

What are some adverse effects of taking opioids ?

A

Constipation
Sedation
Nausea and vomiting